Acceleromyography improves detection of residual neuromuscular blockade in children

Ansermino, J. Mark; Sanderson, Peter M.; Bevan, Joan C.; Bevan, David R.

doi:10.1007/bf03011772

Cited by 32 publications

(28 citation statements)

References 22 publications

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“…Some studies have supported its use by finding that acceleromyography compares closely with other more sophisticated equipment [26,27], whereas clinical trials using the TOF-Guard to measure neuromuscular function have been increased. However, it is not yet accepted as a monitor of definitive studies of neuromuscular blocking agents in anesthesia probably because it does not register the neuromuscular function in a continuous fashion, and can generate "noise" in the measurement of the effect [20].…”

Section: Discussionmentioning

confidence: 99%

Effect of mivacurium 200 and 250 μg/kg in infants during isoflurane anesthesia: a randomized controlled trial [ISRCTN07742712]

et al. 2001

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Background: Infants usually respond differently to a neuromuscular relaxant compared to children or adults. Isoflurane is commonly used as an anesthetic gas in infants. In an RCT design, we investigated whether a dose of mivacurium 250 µg/kg results in faster onset of action than 200 µg/kg in infants under isoflurane anesthesia. Spontaneous recovery times and cardiovascular response were also evaluated.

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Section: Discussionmentioning

confidence: 99%

Effect of mivacurium 200 and 250 μg/kg in infants during isoflurane anesthesia: a randomized controlled trial [ISRCTN07742712]

et al. 2001

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“…actual quantification of the TOF ratio, can help the clinician when timing the administration of a reversal agent, but only with objective monitoring is it possible to exclude potentially clinically significant PORC (TOF ratio ≤ 0.9). Every paper published so far on objective monitoring has documented a significant decrease in PORC when objective monitoring was used [58, 67, 71, 75–77, 92, 93]. Good practice based on evidence therefore dictates that objective monitoring should be the acceptable standard of care whenever a NMB is used.…”

Section: Postoperative Residual Curarisationmentioning

confidence: 99%

The undesirable effects of neuromuscular blocking drugs

Claudius¹,

Garvey

Viby‐Mogensen

2009

Anaesthesia

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SummaryNeuromuscular blocking drugs are designed to bind to the nicotinic receptor at the neuromuscular junction. However, they also interact with other acetylcholine receptors in the body. Binding to these receptors causes adverse effects that vary with the specificity for the cholinergic receptor in question. Moreover, all neuromuscular blocking drugs may cause hypersensitivity reactions. Often the symptoms are mild and self-limiting but massive histamine release can cause systematic reactions with circulatory and respiratory symptoms and signs. At the end of anaesthesia, no residual effect of a neuromuscular blocking drug should be present. However, the huge variability in response to neuromuscular blocking drugs makes it impossible to predict which patient will suffer postoperative residual curarization. This article discusses the undesirable effects of the currently available neuromuscular blocking drugs including the definitions, diagnosis and causes of hypersensitivity reactions and postoperative residual curarisation.

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“…There is a good correlation between simultaneously recorded measurements but the variations of the values for individual patients measured by AMG compared with EMG and MMG are wide (22). Other investigators concluded that the limits of agreement between AMG and EMG are acceptable compared with their wide discrepancy with clinical assessment, visual or tactile (23).…”

Section: Unsolved Problemsmentioning

confidence: 99%